Ati Med/Surg Chronic Care Exam 1

EXAM COVERS: 1. FIRST AIDE AND FLUID IMBALANCES (Ch.8 + 10) 2. PERIOPERATIVE CARE (Ch.15-17) 3. MUSCULOSKELETAL DISORDERS (Ch.20, 52-54) (Connection Check 8.1 ) The nurse understands that cerebrospinal fluid is considered which type of fluid? A. Intracellular B. Interstitial C. Transcellular D. Plasma C. Transcellular (Connection Check 8.2 ) The nurse correlates which physiological response to the secretion of natriuretic peptide hormones? A. Increase in urine output B. Increase in blood pressure C. Increase in blood volume D. Increase in serum osmolality A. Increase in urine output (Connection Check 8.3 ) The nurse assesses for which clinical manifestations in the patient with dehydration? (Select all that apply.) A. Increased urine specific gravity B. Increased serum BUN C. Increased serum osmolality D. Decreased serum osmolality E. Decreased BUN-to-creatinine ratio A. Increased urine specific gravity B. Increased serum BUN C. Increased serum osmolality (Connection Check 8.4 ) In the aging adult, which of the following impacts food and fluid intake? A. Increased sensitivity to smells B. Increased sensitivity to texture in foods C. Decreased manual dexterity D. Decreased olfactory function D. Decreased olfactory function (Connection Check 8.5 ) The nurse assesses for which clinical manifestations in the patient with hypervolemia? A. Bradycardia B. S3 heart sound C. Postural hypotension D. Decreased skin turgor B. S3 heart sound (Connection Check 10.1 ) The nurse recognizes that which patient may need infusion therapy? (Select all that apply.) A. Patient who sustained trauma presenting to the emergency department B. Patient with osteomyelitis receiving IV antibiotics at home C. High school teacher during an annual health appraisal D. Patient with cancer receiving parenteral chemotherapy E. Patient with multiple sclerosis in remission A. Patient who sustained trauma presenting to the emergency department B. Patient with osteomyelitis receiving IV antibiotics at home D. Patient with cancer receiving parenteral chemotherapy (Connection Check 10.2 ) The nurse anticipates which fluid movement when administering an isotonic IV fluid to a patient? A. Causes fluid to move from the cells into the intravascular space B. Causes fluid to move from the intravascular space into the intracellular space C. Causes no or equal movement of fluid into or out of cells D. Causes fluid to move from the intravascular space into the interstitial spaces C. Causes no or equal movement of fluid into or out of cells (Connection Check 15.1 ) You are preparing a patient for surgery and have asked her to verify her information on her patient identification band. She tells you that the birth date is incorrect on her identification band. The most appropriate action by the nurse at this time is which of the following? A. Cross out the birth date and put the correct one in its place with the nurse’s initials. B. Ask the family members to validate the patient’s birth date. C. Call the surgeon’s office to validate the birth date. D. Ask the admissions office to please send a corrected identification band. D. Ask the admissions office to please send a corrected identification band. (Connection Check 15.2 ) The nurse should report which of the following findings from a patient’s history as increasing the risk for DVTs postoperatively? (Select all that apply.) A. History of smoking B. Age C. History of DVTs with previous pregnancy D. Borderline hypertension E. Allergies A. History of smoking C. History of DVTs with previous pregnancy D. Borderline hypertension (Connection Check 15.3 ) Which of the following patients presents the greatest risk for a negative response to anesthesia? A. A 40-y.o. male with high blood pressure B. A 20-y.o. female with no prior surgical history C. A 29-y.o. female with a history of stage II acute renal failure D. An 85-y.o. male who drinks one glass of scotch every night C. A 29-y.o. female with a history of stage II acute renal failure (Connection Check 15.4 ) During the initial assessment and admission questions, the nurse asks Maria for the time of her last oral intake. The patient replies, “I had dinner last night at 8 p.m., but I took a few sips of water this morning with my vitamins. The nurse’s best response is which of the following? A. Explain to the patient that just a sip of water should not be a problem for anesthesia but that the vitamins may be a problem. That information will be passed on to the anesthesiologist. B. Tell the patient that the sip of water is not an issue because it was only a sip. C. Inform the patient that her surgery will not be performed today because the risk is too high for a negative outcome. D. Inform the patient that taking her vitamins before surgery was a good plan. A. Explain to the patient that just a sip of water should not be a problem for anesthesia but that the vitamins may be a problem. That information will be passed on to the anesthesiologist. (Connection Check 15.5 ) Maria’s surgeon has asked that thromboembolic-deterrent (TED) stockings be placed on the patient before surgery as well as sequential compression devices on both legs to the knees. Maria asks the nurse what these devices will do for her. Which response by the nurse is most appropriate? A. “They work together to make sure that you do not have a decrease in arterial blood flow in your legs during the surgery.” B. “They complement each other to prevent blood from backing up in your legs and causing a deep vein thrombosis due to your immobility during the surgery.” C. “They prevent deep tissue clotting during the surgery.” D. “The two devices do the same thing, but one is better during the surgery, and the other is better postoperatively.” B. “They complement each other to prevent blood from backing up in your legs and causing a deep vein thrombosis due to your immobility during the surgery.” (Connection Check 15.6 ) When planning discharge education for a 65-y.o. male who is having a hip replacement, it is appropriate for the nurse to consider which of the following? (Select all that apply.) A. The patient’s resources at home for completing activities of daily living B. The number of stairs in the patient’s home C. Transportation to follow-up appointments D. Pre-existing medical conditions E. The number of bathrooms in the home A. The patient’s resources at home for completing activities of daily living B. The number of stairs in the patient’s home C. Transportation to follow-up appointments D. Pre-existing medical conditions (Connection Check 16.1 ) Which of the following is the identified leader of the surgical team? A. The circulating registered nurse B. The anesthesia provider C. The scrub nurse D. The surgeon D. The surgeon (Connection Check 16.2 ) The OR nurse is completing a perioperative assessment for a patient who is scheduled for exploratory surgery. Which of the following interventions must be completed prior to this patient going into the OR? (Select all that apply.) A. Verify operative consent has been signed. B. Ensure allergy and ID bands are in place. C. Remove the patient’s personal clothing. D. Determine evidence of advance directive. E. Validate completed patient history and physical examination. F. Determine NPO status (last food/fluid consumed). A. Verify operative consent has been signed. B. Ensure allergy and ID bands are in place. C. Remove the patient’s personal clothing. D. Determine evidence of advance directive. E. Validate completed patient history and physical examination. F. Determine NPO status (last food/fluid consumed). (Connection Check 16.3 ) Which of the following is an example of a local anesthetic? A. Diazepam B. Lidocaine C. Pavulon D. Morphine B. Lidocaine (Connection Check 16.4 ) Which of the following is an airway used to support airway management? (Select all that apply.) A. MAC B. MH C. LMA D. ETT E. PCP C. LMA D. ETT